This question is frequently asked in discussion groups: Can a woman take oral contraceptives, if they are prescribed by her doctor for a medical purpose?

Everyone agrees that if the woman is not sexually active, then the contraceptive pill is not morally a contraceptive, and so she may take it. What makes contraception a grave sin is the deliberate choice of an act that is intrinsically ordered toward the deprivation of the procreative meaning from sexual acts. If there are no sexual acts, then there can be no deprivation of the procreative meaning from sexual acts.

But if the woman is married, may she continue to have marital relations with her husband, while she is taking an oral contraceptive for a medical purpose?

On various websites, one can find the incorrect answer, asserted by many different persons, that the wife may take oral contraceptives while continuing to have marital relations. They say that the contraceptive effect of the pill is “an unintended side effect” (a reference to the principle of double effect). However, this common answer is false, for several reasons.

First, the principle of double effect never justifies an intrinsically evil act.

“Principle of Double Effect
“An action that is good in itself that has two effects — an intended and otherwise not reasonably attainable good effect, and an unintended yet foreseen evil effect –is licit, provided there is a due proportion between the intended good and the permitted evil…. The object of the act must not be intrinsically contradictory to one’s fundamental commitment to God and neighbor (including oneself), that is, it must be a good action judged by its moral object (in other words, the action must not be intrinsically evil)….” (Ascension Health, Healthcare Ethics, Key Ethical Principles)

There are three fonts (sources) of morality:
1. intention
2. moral object
3. circumstances
All three fonts must be good for an act to be moral.

Contraception and abortion each have an evil moral object, and therefore each act is intrinsically evil and always gravely immoral. The principle of double effect never justifies an intrinsically evil act.

Second, a good intention is not sufficient to make any act moral. To be moral, an act must have only good intentions, only good in the moral object, and the reasonably anticipated good consequences must outweigh any bad consequences. It is never true that an act is made moral solely by a good intention or purpose, even a medical one.

Third, even unintended bad consequences can make an act immoral. Under the principle of double effect, the bad effect (consequences) cannot be the intended end (the purpose for choosing the act). However, a second condition is that the good effect must outweigh the bad effect. The mere fact that the bad effect is unintended is not sufficient to make the act moral. If the reasonably anticipated bad consequences of an act, unintended though they may be, morally outweigh the good consequences, then the choice of that act is a sin. It is always a sin to knowingly choose to do more harm than good.

Fourth, only a moral means can be used to achieve a moral end. The end never justifies the means. So an intrinsically evil act, such as the use of contraception, especially abortifacient contraception, is never justified by a good intended end, such as a medical purpose.

The passage from Humanae Vitae that is often cited, and misinterpreted, on this point is as follows.

Pope Paul VI: “On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from — provided such impediment is not directly intended for any motive whatsoever.” (Humanae Vitae, n. 15.)

A therapeutic means is permitted to accomplish a therapeutic end, but only provided that the means and the end are both moral. For example, a hysterectomy may be done to treat cancer of the uterus, even though this surgery results in sterility. This act is moral because the surgery is not intrinsically evil.

The phrase “not directly intended” is a reference to the moral object, not to the purpose of the act. The sin of contraception is the intentional choice of an act that is directly ordered toward a deprivation of the procreative meaning of sexual acts. Humanae Vitae specifically excludes contraception as a means, or as an end: “whether as an end or as a means” (Humanae Vitae, n. 14.)

The phrase “for any motive whatsoever” is a reference to the intended end or purpose for which the act is chosen. No motive, intention, or purpose can justify the intentional choice of an act that is directly ordered toward an evil moral object.

And this brings us to the fifth point. The type of contraception considered in this question is a chemical contraceptive that is abortifacient. Sometimes it works by preventing conception. Other times it works by preventing implantation of the conceived prenatal, thereby causing an early abortion. So when someone claims that the use of abortifacient contraception by a sexually active woman is moral for a medical purpose, they are claiming that abortion is moral for a medical purpose.

Humanae Vitae is very clear that a therapeutic reason, i.e. a medical purpose, never justifies any direct abortion. But abortifacient contraception is a type of direct abortion. Therefore, abortifacient contraception is not justified for a medical purpose.

Sixth, we may not do evil that good may come of it.

Pope Paul VI: “Though it is true that sometimes it is lawful to tolerate a lesser moral evil in order to avoid a greater evil or in order to promote a greater good, it is never lawful, even for the gravest reasons, to do evil that good may come of it — in other words, to intend directly something which of its very nature contradicts the moral order, and which must therefore be judged unworthy of man, even though the intention is to protect or promote the welfare of an individual, of a family or of society in general.” (Humanae Vitae, n. 14).

The phrasing “to intend directly something which of its very nature contradicts the moral order” is a reference to the second font of morality, the moral object. The second font is the intentional choice of an act that is directly ordered toward an end in terms of morality, called the moral object. When the moral object is evil, the act is intrinsically evil; it is evil by its very nature, and therefore inherently contrary to the moral order. So even if the intention (the intended end or purpose) of an act is to “promote the welfare of an individual” (e.g. a medical purpose), it is not moral — “even for the gravest reasons” — to intentionally choose contraception or abortifacient contraception or any other intrinsically evil act as a means to that good end.

Seventh, the Magisterium teaches that intrinsically evil acts are never justified by intention (the purpose for which the act was chosen), nor by circumstances (which includes the good and bad consequences).

Pope John Paul II: “Consequently, circumstances or intentions can never transform an act, intrinsically evil by virtue of its object, into an act ‘subjectively’ good or defensible as a choice.” (Veritatis Splendor, n. 81).

So a medical purpose or therapeutic intention never justifies the intrinsically evil acts of contraception or abortion. It is not possible for an intention to cause an evil moral object to become an unintended side effect. The intentional choice to use contraception and to remain sexually active is the choice of an intrinsically disordered act, an act that is immoral by the very nature of the act.

Pope John Paul II: “No circumstance, no purpose, no law whatsoever can ever make licit an act which is intrinsically illicit, since it is contrary to the Law of God which is written in every human heart, knowable by reason itself, and proclaimed by the Church.” (Evangelium Vitae, n. 62).

Therefore, the use of abortifacient contraception by a woman who is sexually active is always gravely immoral, and is never justified by a medical purpose, no matter how dire the circumstances. The woman may take the oral contraceptives and refrain from all sexual acts, or she may seek some other medical treatment while continuing to have natural marital relations. She may not morally choose both to use abortifacient contraception AND engage in contracepted sexual acts.

Is abortion moral for a medical purpose, for the sake of the health or even the life of the mother? No, it is not. All direct abortion is intrinsically evil and always gravely immoral. Therefore, all abortifacient contraception is also intrinsically evil and always gravely immoral, even for the sake of the health of the woman. How is it that the same commentators who correctly condemn direct abortion to save the life of the mother, nevertheless permit abortifacient contraception so that the wife can continue to have sexual relations with her husband? Has sex become so high a value in life that it even justifies abortion? Such evil!